Rotator cuff tears

What are they?
The rotator cuff is composed of 4 muscles and tendons that hold the ball (the humeral head) centered into the socket (the glenoid) during movement. The muscles are the red and the tendons are the white structures attaching to the bone in this diagram, which you can also review on the anatomy page. These tendons can tear, either by long term overuse and wear, or by one sudden injury. The most important one of those four tendons is the one on top of the rotator cuff, and it is called the supraspinatus.

What does one feel like?
Rotator cuff tears are very common, but tears all the way through the thickness of the tendon are not common in throwing athletes. They feel painful at the side of the shoulder, and often the patient cannot lift the arm to the side or overhead without weakness and pain.

How are they treated?
Nonoperative treatment is usually successful for tears that are not through the full thickness of the tendon. This involves anti-inflammatory medicines, physical therapy, and sometimes cortisone injections.

Operative treatment is required for tears that are through the full thickness of the tendon. It is infrequently needed for the few patients with partial tears that do not get better with nonoperative treatment. It is arthroscopic surgery with very small skin incisions and many advantages over older open surgery techniques.

How long will I be out of throwing?
If nonoperative treatment is successful, about 4 months.
If surgery is required, about 9-12 months.